Provider Demographics
NPI:1174951883
Name:NASTASEE, PHILIP ANTHONY (PHD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ANTHONY
Last Name:NASTASEE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2718
Mailing Address - Country:US
Mailing Address - Phone:610-966-5131
Mailing Address - Fax:610-421-8251
Practice Address - Street 1:216 N 4TH ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2718
Practice Address - Country:US
Practice Address - Phone:610-966-5131
Practice Address - Fax:610-421-8251
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003005-L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling